Cryoballoon ablation of atrial fibrillation in a patient with partial anomalous pulmonary vein drainage in the superior vena cava

Figure 1. A: Anteroposterior (AP) and posteroanterior (PA) view of the left (red) and right atrium (blue), derived from a computed tomography (CT) scan reconstruction. This cardiac CT imaging showed a partial anomalous pulmonary vein drainage (PAPVD) in the superior vena cava (SVC) with a superior and inferior branch, and a left common pulmonary vein (LCPV) and right inferior pulmonary vein (RIPV) with drainage in the left atrium. B: AP fluoroscopic image with the cryoballoon (CB) at the SVC ostium and a decapolar catheter in the SVC (partially seen).

Figure 2. Right atrium–superior vena cava (SVC) potentials recorded at the ostium of the SVC with the Achieve mapping catheter (Medtronic Inc, Minneapolis, MN). Progressive delaying and real-time isolation of the SVC signals is shown by the arrows. Pacing artefacts during pacing from the decapolar catheter are observed at the right side of the image (started from -20° in order to monitor phrenic nerve function).